Document Detail


Anti-tissue transglutaminase antibodies in the follow-up of adult coeliac disease.
MedLine Citation:
PMID:  19438848     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The detection of auto antibodies directed against tissue transglutaminase (anti-tTG antibodies) has a well-established role in the diagnosis of coeliac disease, but the value of these antibodies in long-term follow-up is controversial. AIMS: To determine if serial anti-tTG antibody measurements could confirm adherence to a gluten-free diet (GFD) and identify patients at risk of disease complications. METHODS: In a 54-month cohort follow-up study, 182 adult patients were assessed. Data recorded included self-assessment of GFD adherence; anti-tTG antibody concentration and serum ferritin, vitamin B12 and folate. Where available, bone mineral density (BMD) and duodenal histology data were retrieved. RESULTS: Persistently elevated anti-tTG antibody levels were significantly associated with abnormal duodenal histology (P < 0.001), low ferritin (P < 0.01) and poor adherence to the GFD (P < 0.001). The specificity was >85% while the sensitivity was 39-60%. Anti-tTG antibody concentrations fell rapidly following successful initiation of a GFD, and maintenance of normalization identified those who continued to be adherent to the diet. CONCLUSIONS: This study supports a strategy of using anti-tTG antibody concentrations to monitor newly diagnosed and established patients with coeliac disease, and to target dietetic intervention to reduce the risk of complication.
Authors:
C R Dipper; S Maitra; R Thomas; C A Lamb; A P C McLean-Tooke; R Ward; D Smith; G Spickett; J C Mansfield
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Publication Detail:
Type:  Journal Article     Date:  2009-05-12
Journal Detail:
Title:  Alimentary pharmacology & therapeutics     Volume:  30     ISSN:  1365-2036     ISO Abbreviation:  Aliment. Pharmacol. Ther.     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-23     Completed Date:  2010-02-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8707234     Medline TA:  Aliment Pharmacol Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  236-44     Citation Subset:  IM    
Affiliation:
Department of Gastroenterology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Antibodies / blood,  immunology*
Autoantibodies / blood,  immunology*
Bone Density
Celiac Disease / complications,  diet therapy*,  immunology
Diet, Gluten-Free*
Duodenum / anatomy & histology
Female
Ferritins
Follow-Up Studies
Humans
Male
Middle Aged
Patient Compliance
Risk Factors
Transglutaminases / immunology*
Vitamin B 12
Young Adult
Chemical
Reg. No./Substance:
0/Antibodies; 0/Autoantibodies; 68-19-9/Vitamin B 12; 9007-73-2/Ferritins; EC 2.3.2.13/Transglutaminases

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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